General Practice Team Manual Patient Inserts for Heart Failure

By Danny Hunter,2014-01-10 21:18
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General Practice Team Manual Patient Inserts for Heart Failure

Patient Inserts for Heart Failure


You may have heard people talk about a low-sodium diet or a low-salt diet

    and may wonder if they are the same. Doctors, nurses and dieticians usually

    use the words sodium and salt to mean the same thing.

It is important to have less sodium in what you eat because Heart failure

    causes the body to hold on to extra sodium.

? The sodium causes extra fluid to build up in your body.

    ? The extra fluid makes your heart work harder.

    ? It also causes symptoms such as swelling of the ankles feet or abdomen,

    shortness of breath, or weight gain.

    ? It may take some time for your taste buds to adapt to less sodium (about 2


    ? But it can help you feel better and help your pills to work better.

A few facts about Sodium

? Sodium is a mineral found naturally in foods but usually in small


    ? Sodium is found in large amounts in table salt (sodium chloride). ? Sodium is frequently added to processed foods (commercially prepared

    foods), sometimes in very large amounts ? To start with foods may taste very different when you have less sodium in

    your food.

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How to cut down on Sodium

    ? No salt added during cooking and none added at the table

    ? Avoid stock cubes, powders, seasoned salt or kelp salt in the preparation

    of foods.

    ? Check any processed foods with the list provided to make the best choice.

    ? Read labels carefully to check for the word salt, sodium chloride or brine. ? Low in sodium means less than 120mgs per 100g serving. ? If you are unsure about a food and its salt content

     it is best to leave it out

    ? When dining out or buying takeaway foods ask for “no added salt” or no

    MSG, (such as food in Asian takeaways)

    ? Check with your doctor or dietician before using salt substitutes,

    medication or antacids.

    ? Try to eat fresh foods that are naturally low in sodium,

    ? Add herbs, spices, pepper and lemon juice to your cooking to help boost

    the flavour.

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    Food group Best Choice

    Fresh Milk Buttermilk Yoghurt Malted milk Milk and Milk Products Flavoured Milk Thick shakes

    Smoked, salted, cured and Fresh or frozen canned fish, meat or poultry

    Beef, lamb, pork E.g. bacon, corned beef,

    Meat, Fish, Chicken Veal, chicken, turkey, fish ham, sausages, hot dogs,

    Tuna in spring water saveloys, polonies, salami,

    canned salmon, tuna in brine

    Pickled eggs Fresh eggs Eggs

    Tofu Tofu in brine Low sodium peanut butter Vegemite/marmite/peanut

     butter Meat Substitutes Dried peas, lentils and dried Tinned beans and tinned

    beans bean products

    Regular tinned vegetables

    and vegetable juices Fresh, frozen, dehydrated Sauerkraut and low sodium tinned Vegetables Pickled vegetables, olives, vegetables gherkins, onions

    Frozen vegetables in sauce

    All fruits and juices, raw, None Fruits stewed and dried

    All other cheeses and cheese

    Low fat cottage cheese spread especially high

    Cottage cheese sodium ones such as feta, Cheese Ricotta parmesan, blue vein and


    Potatoes/kumara Instant potato mixes Rice, barley, noodles, Salted or lite potato chips and

    Potato, Rice, Pasta spaghetti, macaroni, lentils, snack chips burghul wheat, dried beans Instant rice and pasta mixes Do not add any salt, cheese

    and split peas Tinned spaghetti and baked or other high sodium

    Lower salt baked beans and beans ingredients when cooking

    spaghetti Instant noodles Tuna in spring water Smoked Salmon Egg Luncheon Roast beef/lamb Salami

    Chicken (fresh, cooked) Pastrami

    Sandwich Fillings Turkey (fresh, cooked) Bacon

    Salad vegetables Ham

    Tomato Sausages Jam/honey Pate

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Food group

    Breads: All bread Fruit breads Cheese breads contains a significant Cinnamon buns Savoury breads amount of sodium limit Pita bread Focaccia bread to 6 slices/day

    Ryvita Country Crackers

    Real Foods corn thins

    Arnotts Adera cream wafers

    Sakata rice crackers satay Most other crackers are high Crackers chicken in sodium

    Huntly & Palmer low fat

    cream cracker

Biscuits Sweet biscuits and most muesli bars are reasonably low in sodium.

    They are a snack food and should be limited if you are overweight or have diabetes.

    Unsalted butter

    Butter, Margarine, Oil Peanut oil Use butter and margarine in

    Canola oil small amounts as high in Most are moderate-high in

    Salad and cooking oil sodium sodium content therefore

    Soya bean oil use sparingly

    Puffed corn

    Muesli toasted/natural Coco puffs/pops Porridge (without salt) Cornflakes Hubbards Thank goodness Rice bubbles/ricies/rice Cereals Very Fruitful Flakes pops Kelloggs Justrite Mini Wheats Bran & sultanas Sanitarium Weetbix, Puffed Bran flakes Wheat, Honey Puffs, Uncle

    Toby‟s instant oats

    Watties lite tomato sauce

    Tomato Salsa-El Paso

    Watties tomatoes in spicy

    pepper sauce

    Watties Tuscan style Most other sauces are very tomatoes high in sodium e.g. soy Mother Earth Pasta Sauce Sauces sauce, oyster sauce, Watties Just Add Simmer Worcestershire sauce and Most are high sodium Sauce Sweet & Sour chilli sauce. chicken

    Foodtown Signature Range


    Dolmio Reduced Salt

    Bolognaise sauce

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    Salt, salt substitutes

    Fresh or dried herbs Garlic salt

    Fresh or dried spices Celery salt

    Pepper Onion salt

    Vinegar Sea salt Seasonings, Lemon or lime juice Rock salt Dressings Chopped onion Kelp salt

    Fresh garlic MSG

    Mustard powder Bovril/Bisto

    Wine/Sherry Stock cubes/powder


    Plain unsalted nuts

    Popcorn plain or sweet

    Snack Foods All salted nuts

    Less salty chips Salted popcorn Most are higher in

    Most salted potato chips sodium need to Bluebird grain waves

    Commercial dips be considered as Eta Naturals

    „treat‟ food - Ripples

    Shultz pretzels


    Lower sodium soups All regular tinned or Hint:: Use low dehydrated commercial

    Such as sodium soups ingredients in Home-made or reduced sodium Instant soup mixes home-made commercial soups


    Fish and chips (specify no salt) Pizza Takeaways Hamburgers (specify no tomato Chinese takeaways Hint: Ask for no sauce, no cheese, no bacon, no Kentucky Fried Chicken added salt dressing)

    Rotisserie chicken (no skin)

    Tomato juice

    Vegetable juice

    Soda water e.g. Schweppes

    Energy drinks e.g. Red Bull,

    Ikon Beverages Any beverages except those excluded Electrolyte replacement

    drinks e.g. PowerAde


    Beef tea

    (Thanks to Middlemore dieticians dept)

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    Information on Common Heart Failure Medications

The right pills can help the way your heart works and help protect your heart from

    further damage. No matter how well you feel, don‟t stop taking them without talking to

    your doctor or nurse. It is important to tell your doctor or nurse if you are planning to

    become pregnant as these tablets should not be taken during pregnancy

ACE Inhibitors (Accupril, Enalapril, Captopril, Quinapril, Cilazopril)

These work by keeping the body from making as much angiotensin, a substance that is

    produced by the body that causes blood vessels to narrow and can make heart failure

    worse. ACE inhibitors have been shown to help heart failure patients live longer and feel


They do not cause many side effects but can cause:

    ? A cough that doesn‟t go away,

    ? May affect the kidneys or potassium level

    ? Can VERY RARELY cause sudden swelling of the lips or throat, which needs


Diuretics (Lasix, Amizide, Frusemide,).

Diuretics help to remove extra fluid from the body. Less fluid in the lungs makes it easier

    to breathe and less fluid in the body means less swelling in other parts of the body such

    as the ankles. Most diuretics are short acting and best taken early in the day.

    ? Potassium tablets may also be needed as these tablets may cause a loss of


    ? Blood tests for potassium level needs to be checked regularly.

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Aldosterone antagonists ( Spironolactone) block the effect of a stress hormone called

    aldosterone, which can make heart failure worse.

    ? Can cause breast tenderness or enlargement, especially in men

    ? Increase potassium levels.

    ? Blood test for potassium needs to be checked regularly OR WHEN YOU ARE


    Digoxin (Lanoxin).

Digoxin makes the heart beat more strongly so that more blood is pumped out with each

    beat. Not everyone with heart failure needs digoxin

Too much digoxin can cause:

    ? Loss of appetite, bad taste in the mouth

    ? Bluish or yellow vision

    ? Palpitations, skipped heart beats, fast hear rates.

Betablockers ( Metoprolol , Carvedilol).

Beta blockers block the effects of harmful stress hormones that can make heart

    failure worse.

Sometimes people feel worse for a few weeks after starting a beta-blocker, but

    then start to feel better.

    ? They can cause a build up of fluid in the body

    ? They can make asthma worse

    ? Dizziness, slow heart rate, low blood pressure

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Some medicines should not be taken together because they can make

    heart failure worse.

Non-Steroidal Anti-Inflammatory Medicines sometimes called NSAIDs are

    used to relieve pain,

    NSAIDs include medicines such as aspirin, ibuprofen, indomethacin,

    naproxen, and diclofenac.

    It is always a good idea to discuss with your GP before taking any

    medications you have not been prescribed.

Ingredients in some alternative pills can interfere with the action of heart

    failure pills and this could be harmful and should be avoided.

    ? Ephedrine metabolites

    ? Chinese herbs

    ? Hawthorne (cratageus) products

    ? Ephedra (ma huang)

And these should not be taken with anticoagulants like Warfarin.

    ?Garlic ? Ginseng ?Gingko ? Coenzyme Q-10

    (Thanks to June Poole Cardiac Rehab Nurse Specialist)

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If you take notice of any symptoms as soon as they start, you will be able to

    manage them better.

The easiest way is to weigh yourself daily. This will help you find out if fluid is

    building up in your body.

    ? Weigh yourself every day, on the same scales, such as each morning,

    after you urinate and before you have breakfast.

    ? Write this weight down in your wellness plan and bring your wellness

    plan to your GP team

    ? Your target weight, that is, your weight with no extra fluid,


    ? If your weight increases above this, follow the action plan

    ? If your weight decreases below your target weight, you may need less


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